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Long-term follow-up of a randomised controlled trial of prolonged exposure therapy and supportive counselling for post-traumatic stress disorder in adolescents: a task-shifted intervention

Published online by Cambridge University Press:  06 August 2020

Jaco Rossouw Open the ORCID record for Jaco Rossouw [Opens in a new window] ,
Elna Yadin ,
Debra Alexander  and
Soraya Seedat
Jaco Rossouw*
Affiliation:
Department of Psychiatry, Stellenbosch University, Stellenbosch, Western Cape, South Africa
Elna Yadin
Affiliation:
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
Debra Alexander
Affiliation:
Department of Psychiatry, Stellenbosch University, Stellenbosch, Western Cape, South Africa
Soraya Seedat
Affiliation:
Department of Psychiatry, Stellenbosch University, Stellenbosch, Western Cape, South Africa
*
Author for correspondence: Jaco Rossouw, E-mail: [email protected]
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Abstract

Background

Empirical evidence on the longer-term effectiveness of evidence-based treatments for adolescents with post-traumatic stress disorder (PTSD) in low-resource settings is needed. The aim of the study was to evaluate the maintenance of treatment gains achieved in a comparative study of effectiveness of prolonged exposure therapy for adolescents (PE-A) and supportive counselling (SC) in adolescents with PTSD up to 24-months post-treatment.

Method

Sixty-three adolescents (13–18 years) with PTSD were randomly assigned to receive either of the interventions comprising 7–14 sessions of treatment provided by trained and supervised non-specialist health workers (NSHWs). The primary outcome measure was PTSD symptom severity, as independently assessed on the Child PTSD Symptom Scale, at pretreatment, post-treatment, and at 3-, 6-, 12- and 24-months post-treatment follow-up (FU) evaluations.

Results

Participants in both the prolonged exposure and SC treatment groups attained a significant reduction in PTSD symptoms and maintained this reduction in PTSD symptoms at 12- and 24-month assessment. Participants receiving prolonged exposure experienced greater improvement on the PTSD symptom severity scale than those receiving SC at 12-months FU [difference in PE-A v. SC mean scores = 9.24, 95% CI (3.66–14.83), p < 0.001; g = 0.88] and at 24-months FU [difference in PE-A v. SC mean scores = 9.35, 95% CI (3.53–15.17), p = 0.002; g = 0.68].

Conclusions

Adolescents with PTSD continued to experience greater benefit from prolonged exposure treatment than SC provided by NSHWs in a community setting 12 and 24 months after completion of treatment.

Keywords

Cognitive-behavioural therapieslow- and middle-income countriespost-traumatic stress disorderrandomised controlled trialtask-shiftingtreatment outcome
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 6 , April 2022 , pp. 1022 - 1030
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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